Session Title: Free Paper Session 27: AMD VI
Session Date/Time: Sunday 10/09/2017 | 12:00-13:30
Paper Time: 12:42
Venue: Room 117
First Author: : L.Heng UK
Co Author(s): : R. Hamilton J. Marshall S. Sivaprasad
It was hypothesized that increasing Matrix metalloproteinase(MMP) activity rejuvenates transportation across the Bruch’s membrane (BrM) and prevent age-related processes in the macular. Previous studies demonstrated an increase in MMP release secondary to RPE migration initiated by deliberate injury using lasers. However, conventional lasers causes collateral photoreceptor cell damage. The 2RT-laser is a nanosecond, doubled-frequency Nd:Yag laser with a speckled beam configuration within a 400µm spot size. The main objectives of this pilot study were to determine the efficacy and safety of this novel laser as a viable therapeutic intervention to retard the onset of AMD.
Moorfields Eye Hospital, Biomedical Research Centre for Ophthlamology
23 patients diagnosed with bilateral early AMD (AREDS 2 and 3) were recruited with one eye randomised to either 2RT-laser or sham-laser. Visual function was measured at 6 and 12 months(primary outcome). Safety outcomes were determined by perimetric changes and gross morphological changes on fundus autoflorecence and OCT.
11 patients underwent 2RT laser with energy ranging 0.1 to 0.3mJ and 52 to 102 laser spots. At 6 and 12 months, the change in VA for cases compared to controls were +5.0(±5.67) versus -0.33(±3.28)EDTRS letters and +1.73±5.00 versus -0.25± 4.29 letters respectively. Perimetric changes were equivocal in both arms at both time points. Hyperflorescent laser changes were noted on autoflorescence which showed corresponding disruption limited to the outer segment layer on OCT.
The current study provides evidence that the 2RT laser is safer than the current millisecond laser. However, further well-powered study would be required to better evaluate its efficacy as a prophylactic therapy for AMD.